Влияние инфляции на взаимосвязь стабилизации и роста экономики некоторых стран Восточной Европы и бывшего СССР

In many countries, particularly in sub-Saharan Africa, Demographic and Health Surveys (DHSs) are the main way of estimating HIV prevalence nationally in the general population. Some DHSs record the longitude and latitude of the survey clusters.We present three methodological approaches for mapping spatial variations in HIV prevalence using the DHSs. These approaches are applied to simulated DHS samplings from a model country. The estimated surfaces are then compared with the model’s initial surface.We demonstrate that a method using kernel estimators with adaptive bandwidths size of equal number of persons observed can be used to estimate the main regional trends in epidemics. Application to Burkina Faso’s 2003 DHS data provides a plausible image of that country’s epidemiological situation

HIV-1 disease progression in immune-competent HIV-1-infected and breastfeeding mothers participating in the ANRS 12174 clinical trial in Burkina Faso, South Africa, Uganda and Zambia: a cohort study

International audienceObjective We have assessed HIV-1 disease progression among HIV-1-positive mothers in relation to duration of any or exclusive breast feeding in the context of ANRS 12174 trial.Methods The analysis was completed on 203, 212, 272 and 529 HIV-1-positive and lactating mothers with CD4 count >350 cells/µL from Burkina Faso, South Africa, Uganda and Zambia, respectively. The trial compared lamivudine and lopinavir/ritonavir as a peri-exposure prophylaxis during a 50-week follow-up time. A multiple logistic regression model was run with the mothers’ weight, CD4 count and HIV-1 viral load as separate dependent variables, then combined into a dependent composite endpoint called HIV-1 disease progression where HIV-1 viral load was replaced by the HIV-1 clinical stage. Exclusive or predominant breast feeding (EPBF) and any breastfeeding duration were the key explanatory variables.Results In the adjusted model, the associations between EPBF duration and weight change, CD4 cell count and the HIV-1 viral load were consistently insignificant. The CD4 cell count was associated with a significantly higher mothers’ body mass index (BMI; a mean increase of 4.9 (95% CI 2.1 to 7.7) CD4 cells/µL per each additional kilogram per square metre of BMI) and haemoglobin concentration (19.4 (95% CI 11.4 to 27.4) CD4 cells/µL per each additional gram per decilitre of haemoglobin concentration). There was no significant association between EPBF duration and HIV-1 disease progression. A higher education level was a factor associated with a slower HIV-1 disease progression.Conclusion Breast feeding was not a risk factor for a faster progression of HIV-1 disease in mothers of this cohort with a baseline CD4 cell count >350 cells/µL

Mitochondrial DNA parameters in blood of infants receiving lopinavir/ritonavir or lamivudine prophylaxis to prevent breastfeeding transmission of HIV-1

Children who are human immunodeficiency virus (HIV)-exposed but uninfected (CHEU) accumulate maternal HIV and antiretroviral exposures through pregnancy, postnatal prophylaxis, and breastfeeding. Here, we compared the dynamics of mitochondrial DNA (mtDNA) parameters in African breastfed CHEU receiving lopinavir/ritonavir (LPV/r) or lamivudine (3TC) pre-exposure prophylaxis during the first year of life. The number of mtDNA copies per cell (MCN) and the proportion of deleted mtDNA (MDD) were assessed at day 7 and at week 50 post-delivery (PrEP group). mtDNA depletion was defined as a 50% or more decrease from the initial value, and mtDNA deletions was the detection of mtDNA molecules with large DNA fragment loss. We also performed a sub-analysis with CHEU who did not receive a prophylactic treatment in South Africa (control group). From day seven to week 50, MCN decreased with a median of 41.7% (interquartile range, IQR: 12.1; 64.4) in the PrEP group. The proportion of children with mtDNA depletion was not significantly different between the two prophylactic regimens. Poisson regressions showed that LPV/r and 3TC were associated with mtDNA depletion (reference: control group; LPV/r: PR = 1.75 (CI95%: 1.15–2.68), p < 0.01; 3TC: PR = 1.54 (CI95%: 1.00–2.37), p = 0.05). Moreover, the proportion of children with MDD was unexpectedly high before randomisation in both groups. Long-term health impacts of these mitochondrial DNA parameters should be investigated further for both CHEU and HIV-infected children receiving LPV/r- or 3TC- based regimens.http://www.mdpi.com/journal/jcmpm2021Paediatrics and Child Healt

Méthodes pour cartographier les tendances régionales de la prévalence du VIH à partir des Enquêtes Démographiques et de Santé (EDS)

Pour de nombreux pays, en particulier en Afrique subsaharienne, les Enquêtes Démographiques et de Santé (EDS) constituent la principale estimation de la prévalence du VIH au niveau national et en population générale. Plusieurs EDS collectent la longitude et la latitude des grappes enquêtées.Dans cet article, nous présentons trois approches méthodologiques pour cartographier les variations spatiales de la prévalence du VIH à partir des EDS. Ces approches sont appliquées à des simulations d’EDS échantillonnées à partir d’un pays modèle. Les surfaces estimées sont alors comparées à la surface initiale du modèle.Nous montrons qu’une méthode utilisant des estimateurs à noyau à fenêtres adaptatives de même effectif permet d’estimer les principales tendances régionales des épidémies. Son application aux données de l’EDS 2003 du Burkina Faso fournit une image plausible de la situation épidémiologique dans ce pays.For many countries, in particular in sub-Saharan Africa, Demographic and Health Surveys (DHS) are the main estimates of HIV prevalence at national levels in general population. Several DHS collect longitude and latitude of surveyed clusters.In this paper, we present three methodological approaches for mapping spatial variations of HIV prevalence from DHS. These approaches are applied to DHS simulation sampled from a model country. The estimated surfaces are then compared with the initial surface of the model.We show that a method using kernel estimators with adaptive bandwidths of the same number of observed people allows estimating main regional trends of the epidemics. Its application to data from 2003 DHS of Burkina Faso give a plausible picture of the epidemiological situation in this country

Methods for mapping regional trends of HIV prevalence from Demographic and Health Surveys (DHS)

For many countries, in particular in sub-Saharan Africa, Demographic and Health Surveys (DHS) are the main estimates of HIV prevalence at national levels in general population. Several DHS collect longitude and latitude of surveyed clusters.In this paper, we present three methodological approaches for mapping spatial variations of HIV prevalence from DHS. These approaches are applied to DHS simulation sampled from a model country. The estimated surfaces are then compared with the initial surface of the model.We show that a method using kernel estimators with adaptive bandwidths of the same number of observed people allows estimating main regional trends of the epidemics. Its application to data from 2003 DHS of Burkina Faso give a plausible picture of the epidemiological situation in this country. Keywords: interpolation, regional trends, methodology, demographic and health surveys, developing countries, HI

Cartographier les données des Enquêtes Démographiques et de Santé à partir des coordonnées des zones d'enquête

International audienceLes enquêtes démographiques et de santé (EDS) constituent une source de données standardisées bien connues des démographes. Nombre d’entre elles incorporent depuis longtemps les coordonnées longitude/latitude des zones enquêtées (grappes). Cependant, peu de travaux cartographiques exploitent cette information, principalement en raison d’un problème méthodologique. En effet, le nombre de personnes enquêtées dans une grappe est le plus souvent trop réduit (moins de 40) pour calculer des indicateurs statistiquement significatifs par grappe. D’autre part, les méthodes d’interpolation spatiale classique présupposent une mesure relativement précise du phénomène étudié en chaque point. Notre approche consiste donc à estimer la prévalence d’un phénomène en chaque grappe, à partir des grappes voisines, en ayant recours à des cercles de même effectif, puis à interpoler ces prévalences estimées par krigeage. Il est possible par ailleurs de prendre en compte le milieu de résidence après recodification. Outre l’application de cette approche à la prévalence du VIH du Burkina Faso et du Cameroun, nous présentons les résultats obtenus par simulation d’EDS sur un pays modèle

Estimating effect of non response on HIV prevalence estimates from Demographic and Health Surveys

AimIn most countries in Sub-Saharan Africa, Demographic and Health Surveys (DHS) with HIV testing became the only measure of HIV prevalence in general population. Significant non response rate were often cited to explain differences between DHS results and estimations from sentinel surveillance in antenatal clinics. The objective of this presentation consists to predict with multivariate models the prevalence of non tested persons in order to estimate the effect of non response on national estimates.Method / IssueWe used data from 9 DHS surveys (Burkina Faso 2003, Cameroon 2004, Ethiopia 2005, Ghana 2003, Kenya 2003, Lesotho 2004, Malawi 2004, Senegal 2005 and Tanzanie 2003) where HIV results could be linked with data from household and individual questionnaires. Logistic regression were calculated for each country, separately for men and women 15-49 years old, with common predictor variables : region, place of residence, age group, education, wealth index, marital status, work status, having radio or television, age at first sexual intercourse, recent sexual activities, using condom at last sexual intercourse, number of partners in last 12 months, smoking, STI in last 12 months, female and male circumcision and willing to care for relative with AIDS. For each group, adjusted prevalence was calculated by using observed prevalence for tested people and estimated prevalence for non tested people.Results / CommentsThe non response rates in these 9 studies vary from 7.9% to 34.2%. Estimated prevalence of non tested persons is usually higher than observed prevalence of tested persons : in 15 groups on 18, the ratio exceeds 1 (it vary from 0.820 to 2.424). Nevertheless, ratios of adjusted prevalence to observed prevalence remain relatively small (from 0.956 to 1.251). Except for men in Lesotho and women in Malawi, differences between adjusted and observed prevalence is less than 0.5 points. In both cases, number of tested persons was small (less than 3’000). No relation was found between non response rate and ratio of non tested to tested or ratio of adjusted prevalence to observed prevalence. Nevertheless, highest ratio of adjusted prevalence to observed prevalence were found for groups with smallest prevalence (<3%). But this effect is probably a consequence of a small statistical power.DiscussionIf differences between adjusted and observed prevalence are more important than in a precedent survey conducted by Mishra et al. in 2006 on 5 DHS, the overall effect of non response bias on national HIV estimates tend to be small. Adjustments need to be interpreted with caution due to the limited information available to predict the prevalence of non tested people, in particular for people who did not answer the individual questionnaire and for whom only household questionnaire data were used

Estimating effect of non response on HIV prevalence estimates from Demographic and Health Surveys

AimIn most countries in Sub-Saharan Africa, Demographic and Health Surveys (DHS) with HIV testing became the only measure of HIV prevalence in general population. Significant non response rate were often cited to explain differences between DHS results and estimations from sentinel surveillance in antenatal clinics. The objective of this presentation consists to predict with multivariate models the prevalence of non tested persons in order to estimate the effect of non response on national estimates.Method / IssueWe used data from 9 DHS surveys (Burkina Faso 2003, Cameroon 2004, Ethiopia 2005, Ghana 2003, Kenya 2003, Lesotho 2004, Malawi 2004, Senegal 2005 and Tanzanie 2003) where HIV results could be linked with data from household and individual questionnaires. Logistic regression were calculated for each country, separately for men and women 15-49 years old, with common predictor variables : region, place of residence, age group, education, wealth index, marital status, work status, having radio or television, age at first sexual intercourse, recent sexual activities, using condom at last sexual intercourse, number of partners in last 12 months, smoking, STI in last 12 months, female and male circumcision and willing to care for relative with AIDS. For each group, adjusted prevalence was calculated by using observed prevalence for tested people and estimated prevalence for non tested people.Results / CommentsThe non response rates in these 9 studies vary from 7.9% to 34.2%. Estimated prevalence of non tested persons is usually higher than observed prevalence of tested persons : in 15 groups on 18, the ratio exceeds 1 (it vary from 0.820 to 2.424). Nevertheless, ratios of adjusted prevalence to observed prevalence remain relatively small (from 0.956 to 1.251). Except for men in Lesotho and women in Malawi, differences between adjusted and observed prevalence is less than 0.5 points. In both cases, number of tested persons was small (less than 3’000). No relation was found between non response rate and ratio of non tested to tested or ratio of adjusted prevalence to observed prevalence. Nevertheless, highest ratio of adjusted prevalence to observed prevalence were found for groups with smallest prevalence (<3%). But this effect is probably a consequence of a small statistical power.DiscussionIf differences between adjusted and observed prevalence are more important than in a precedent survey conducted by Mishra et al. in 2006 on 5 DHS, the overall effect of non response bias on national HIV estimates tend to be small. Adjustments need to be interpreted with caution due to the limited information available to predict the prevalence of non tested people, in particular for people who did not answer the individual questionnaire and for whom only household questionnaire data were used

Reduction of HIV-1 RNA levels with therapy to suppress herpes simplex virus.

BACKGROUND: Epidemiologic data suggest that infection with herpes simplex virus type 2 (HSV-2) is associated with increased genital shedding of human immunodeficiency virus type 1 (HIV-1) RNA and HIV-1 transmissibility. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of HSV suppressive therapy with valacyclovir (at a dose of 500 mg twice daily) in Burkina Faso among women who were seropositive for HIV-1 and HSV-2; all were ineligible for highly active antiretroviral therapy. The patients were followed for 24 weeks (12 weeks before and 12 weeks after randomization). Regression models were used to assess the effect of valacyclovir on the presence and quantity of genital and plasma HIV-1 RNA and genital HSV-2 DNA during treatment, adjusting for baseline values, and to evaluate the effect over time. RESULTS: A total of 140 women were randomly assigned to treatment groups; 136 were included in the analyses. At enrollment, the median CD4 cell count was 446 cells per cubic millimeter, and the mean plasma viral load was 4.44 log10 copies per milliliter. With the use of summary-measures analysis, valacyclovir therapy was found to be associated with a significant decrease in the frequency of genital HIV-1 RNA (odds ratio, 0.41; 95% confidence interval [CI], 0.21 to 0.80) and in the mean quantity of the virus (log(10) copies per milliliter, -0.29; 95% CI, -0.44 to -0.15). However, there was no significant decrease in detection of HIV (risk ratio, 0.93; 95% CI, 0.81 to 1.07). HSV suppressive therapy also reduced the mean plasma HIV-1 RNA level by 0.53 log(10) copy per milliliter (95% CI, -0.72 to -0.35). Repeated-measures analysis showed that these effects became significantly stronger during the 3 months of follow-up. CONCLUSIONS: HSV suppressive therapy significantly reduces genital and plasma HIV-1 RNA levels in dually infected women. This finding may have important implications for HIV control. (ClinicalTrials.gov number, NCT00158509 [ClinicalTrials.gov].)